Clinical and public health professionals committed to the prevention of heart disease and stroke have long had an “image” problem. Purveyors of goods and services now recognized as part of unhealthy lifestyles have long appealingly marketed themselves using terms like “zesty” (for high sodium content), “rich” (for high saturated fat), “satisfying” for cigarettes laden with tar and nicotine, and so on. Various campaigns to improve the US diet, increase physical activity, reduce exposure to tobacco smoke, and encourage other healthy lifestyles have been met with endless jokes and cartoons, lampooning efforts to reduce risky lifestyle behaviors as an attack on an admirable quality of life. At the same time, the preventive cardiology community may not have been optimally effective in a campaign of fear and loathing in conveying the contributions of heart disease and stroke to a very poor quality of life as a motivation to adopt healthy lifestyles and, if necessary, the importance of adhering to treatment regimes to reduce cardiovascular risk.
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